First National Bank of NewtownOnline Certificate of Deposit Application

Applicant Information

Please note, for security reasons you must be an existing customer in order to open a new account online. If you are not an existing customer, please stop by one of
our convenient locations in Bucks County (click here for a list of our branches).

Fields marked with an "*" are required.

* Customer Name :

* If the new CD is to be opened as a* joint account, please indicate the joint name :

* Street Address :

* City :

* State :

* Zip :

* Email Address :

* Daytime Phone Number :

* Account Number where* money will transfer from :

* Amount $ :

Backup Withholding Certifications

Taxpayer ID Number - My correct taxpayer identification number is:

Exempt Receipients - I am an exempt recipient under the Internal Revenue Service Regulations.

Backup Witholding - I am not subject to backup witholding either because I have not been notified that I am subject to backup witholding as a result of failure to report all interest
or dividends, or the Internal Revenue Service has notified me that I am no longer subject to backup witholding and I am a US person (including a US Resident alien)

Certificates of Deposit - Rates and yields are effective as of 1/17/2014.

By clicking the Submit button, you accept the number listed below as your eSignature.

*eSignature :

For security purposes you may be contacted by a representative of First National Bank of Newtown. Your account will be funded
no later than the next business day. You will be receiving a letter in the mail with your new account number.